Abstract
BackgroundAlthough total knee arthroplasty (TKA) is an efficacious treatment for end-stage osteoarthritis, ~20% of patients are dissatisfied with the results. We determined which factors contribute to patient satisfaction and compared the various scoring systems before and after surgery.MethodsIn this retrospective cohort study, 545 patients were enrolled and evaluated preoperatively and 1 year postoperatively. Patient demographics, as well as scores for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF)-12, and 1989 Knee Society Clinical Rating System (1989 KSS), were recorded preoperatively and postoperatively. The possible predictors were introduced into a prediction model. Scores for overall satisfaction and the 2011 Knee Society Score (2011 KSS) were also assessed after TKA to identify the accuracy and agreement of the systems.ResultsThere were 134 male patients and 411 female patients, with an overall prevalence of satisfaction of 83.7% 1 year after surgery. A history of surgery (p < 0.001) and the 1989 KSS and SF-12 were of the utmost importance in the prediction model, whereas the WOMAC score had a vital role postoperatively (change in WOMAC pain score, p < 0.001; change in WOMAC physical function score, p < 0.001; postoperative WOMAC pain score, p = 0.004). C-index of model was 0.898 > 0.70 (95% confidence interval (CI): 0.86-0.94). The Hosmer-Lemeshow test showed a p value of 0.586, and the AUC of external cohort was 0.953 (sensitivity=0.87, specificity=0.97). The agreement between the assessment of overall satisfaction and the 2011 KSS satisfaction assessment was general (Kappa=0.437 > 0.4, p < 0.001).ConclusionA history of surgery, the preoperative 1989 KSS, and the preoperative SF-12 influenced patient satisfaction after primary TKA. We recommend the WOMAC (particularly the pain subscale score) to reflect overall patient satisfaction postoperatively.
Highlights
Total knee arthroplasty (TKA) is an efficacious treatment to improve the function and quality of life of patients with end-stage osteoarthritis of the knee [1,2,3]
We aimed to assess the prevalence of patient satisfaction after total knee arthroplasty (TKA), identify the independent predictors of patient satisfaction preoperatively, and establish a prediction model that could aid in the management of patient satisfaction before and after surgery
Patient satisfaction and prediction model The patient demographics, comorbidities, relevant clinical data and scores of different scales for the study cohort are illustrated in Tables 1 and 2, respectively
Summary
Total knee arthroplasty (TKA) is an efficacious treatment to improve the function and quality of life of patients with end-stage osteoarthritis of the knee [1,2,3]. The different methods of satisfaction reporting and scoring systems lead to difficulty in identifying which patients are truly dissatisfied with the outcomes of primary TKA [3, 8, 9]. Few scholars have compared the different methods of measuring patient satisfaction or assessed the correlation between the focus of restoration and a postoperative scoring system. Total knee arthroplasty (TKA) is an efficacious treatment for end-stage osteoarthritis, ~20% of patients are dissatisfied with the results. We determined which factors contribute to patient satisfaction and compared the various scoring systems before and after surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
